NHS CHECK: Predictors of NHS staff sickness absence and resignations during the pandemic

A large-scale longitudinal study of nearly 11,000 NHS workers across England provides fresh insight into factors driving sickness absence and the intention to leave the profession during the COVID-19 pandemic.

The NIHR ARC West led paper, published in BMJ Open, used baseline and 12 month follow-up data from NHS staff surveyed as part of the NHS CHECK programme, from April 2020 to February 2022.

NHS CHECK is the largest survey of the mental health and wellbeing of all NHS staff during the COVID-19 pandemic and beyond. It is led by King’s College London and University College London, with the NIHR Applied Research Collaboration (ARC) North Thames co-ordinating involvement from 7 other ARCs including ARC West.

This latest NHS CHECK study found:

• Around 20% of surveyed staff took five or more days off for non-COVID illness during the 12-months of follow-up
• 14% took the same amount of time off for COVID-related illness
• At 12-months, 20% were “actively seeking” work outside their profession
• 24% thought about leaving “several times a week” or daily

Particular groups of staff were more likely to have both frequent absence and intent to quit:

• Younger staff members
• Those in COVID-19 risk groups
• Those with probable mental health issues
• Those reporting low levels of support from colleagues and managers

For example, staff with probable mental health disorders had 89% greater odds of actively seeking work outside the NHS, while workers lacking managerial support (those who felt “not at all” supported) were more than 3.5 times as likely to be job seeking.

Lauren Scott, Senior Research Associate at ARC West and lead author of the study, said:

“Our analysis highlights the importance of social support at work and the strong link between mental health and workforce sustainability.

“NHS staff who don’t feel supported by their colleagues or managers face a significantly greater likelihood of taking sick leave and considering leaving the profession. This is especially true of younger staff, those at higher health risk and those experiencing poor mental health.

“Strengthening workplace support systems and mental health infrastructure may play a pivotal role in retaining our NHS workforce.”

The team’s recommendations include:

1. Train managers in supportive communication and mental health awareness
2. Foster peer networks and team cohesion to build genuine social support
3. Dedicate resources to mental health support, particularly during crisis periods

These suggestions align in part with the NHS Long-Term Workforce Plan.